About 470 million people across the Americas — two in five residents of the region — live with disability caused by at least one neurological disorder or injury to the nervous system, according to a study published on 22 July 2026 in The Lancet Regional Health – Americas. Led by researchers at the Pan American Health Organization (PAHO), the study drew on data from the Global Burden of Disease Study 2023 to analyse 19 neurological conditions and impairments across 38 countries and territories.
A figure of 470 million exceeds the combined populations of the United States and Mexico. As an epidemiological fact, it is a scale that ought to be read as an issue close to everyone.
Mortality is falling, but more people are living with disability
Between 1990 and 2023, age-standardized mortality from neurological disorders declined. Better medical technology and wider prevention meant more people survived severe acute events. But that success creates a different challenge. More survivors live on with lasting impairments and need support over the long term, expanding demand for rehabilitation, assistive devices and long-term care.
The study estimates that in 2023 these conditions caused about 1.1 million deaths and the loss of 37.5 million DALYs (disability-adjusted life years). DALYs combine mortality and disability into a single measure, making visible the states that do not kill but severely constrain daily life. Migraine and tension-type headache are the most prevalent conditions, while in terms of disability burden migraine is followed by dementias such as Alzheimer's disease and by stroke. Gaps between countries are wide: the burden in Haiti, Guyana and Suriname, the most heavily affected, is roughly four times that in Colombia, Peru and Argentina, the least affected.
Preventable risk factors account for much of the burden
Another point the study emphasises is that a substantial share of neurological disease is linked to preventable risk factors. High blood pressure, high blood glucose, obesity, smoking and exposure to lead and air pollution are strongly associated with stroke and dementia. In Latin America, the spread of ultra-processed foods and the decline in physical activity that comes with urbanisation are pronounced, and these risks are accumulating for the next generation.
What determines how severe the resulting disability becomes is access to rehabilitation and to assistive products and technology. Whether someone with stroke sequelae can begin rehabilitation early and obtain suitable assistive devices makes an enormous difference to how far they return to community life. A separate PAHO report published on 20 July — a ten-country survey of health care access among people with disabilities — found that people with disabilities were up to 45% less likely to receive care for cardiovascular disease and diabetes, and 33% less likely to receive screening services such as HPV testing. The management of neurological sequelae and the disability that follows sits on the same continuum of inequity.
Health systems face the question of long-term support
Responding to neurological disorders does not end with acute care. Rehabilitation for the sequelae of stroke and traumatic brain injury, home-care support for dementia, continuous medication management for epilepsy — all require systems that deliver health and social care over the long term and without interruption. This is a field where strengthening primary care and community-based models of care is indispensable (we covered primary care reform in Latin America in an earlier article).
The writer's view
In Japan, when a stroke leaves someone unable to walk, there is a relay of systems — imperfect but real — running from rehabilitation under medical insurance to long-term care insurance, and on to the Comprehensive Support Act for Persons with Disabilities and the public system that subsidises prosthetic and orthotic devices. In many Latin American countries the second half of that relay — community-phase rehabilitation and public provision of assistive devices — is either not established in law or financially fragile. Whether a mechanism exists to support what comes after surviving the acute phase splits the lives of two people with the very same condition.
When I visited a specialist rehabilitation facility in Costa Rica, what struck me was not the standard of care inside the building so much as the distance people had to travel to reach it. Someone who can commute to a specialist centre in the capital, and someone living in a rural village. Even when both are covered on paper by the same public insurance scheme (CCSS), geographic inequality of access was what actually decided who received rehabilitation. Many of the 470 million people in this new estimate are, statistically, "eligible for services" while in practice living outside the reach of travel distances and waiting lists.
The indicators worth watching are national data on the rehabilitation workforce and the state of public schemes for providing assistive products and devices. PAHO has repeatedly flagged shortages of rehabilitation personnel, and combined with this burden estimate that would give a numerical basis for measuring the gap between demand and supply. Now that we have an estimate of demand, the next question is the figures on the supply side.
Glossary
DALYs (disability-adjusted life years) = a health metric combining losses from premature death and from disability. GBD (Global Burden of Disease) = an international research programme that estimates the burden of disease worldwide. PAHO (Pan American Health Organization) = the WHO Regional Office for the Americas. CCSS = Caja Costarricense de Seguro Social, the institution that runs Costa Rica's public health care.
As survival improves, the real question becomes how we support the years people live with disability.
References
- Two in five people in the Americas live with a neurological disorder, new study finds | PAHO/WHO — paho.org
- About 470 million people in Americas have neurological disorders: WHO Report | Gazette NGR — gazettengr.com
- Disability inclusion in health systems and emergency management remains uneven across Latin America and the Caribbean | PAHO/WHO — paho.org
- Disability Inclusion in Health Systems Remains Uneven Across Latin America and the Caribbean | fundsforNGOs — news.fundsforngos.org
※ This article is the author’s commentary based on public information. Please confirm the latest figures, dates and procedures with governments and primary sources. Quotations are kept minimal and sources are cited.
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